Prognostic significance of tissue factor in patients with pancreatic cancer: a systematic review protocol

Abstract

IntroductionPancreatic cancer is a highly aggressive digestive system tumour with poor prognosis. Venous thromboembolism (VTE) is a well-known complication of pancreatic cancer, and tissue factor (TF) contributes to the generation of a hypercoagulable state and thrombotic disease in pancreatic cancer. Several studies showed that an elevated TF level was related to the development of VTE and influenced the survival of patients with pancreatic cancer. Thus, we wish to conduct a systematic review of literature to clarify the prognostic significance of TF in pancreatic cancer.Methods and analysisStudies comparing the circulating microparticle-associated TF (MP TF) level between patients who had pancreatic cancer with and without VTE will be included to evaluate the roles of TF in VTE development. Studies comparing the survival data between patients with high TF expression and low TF expression will also be included to explore the association of TF expression with patient survival. The outcomes are plasma MP TF level and survival endpoints (overall and progression-free survival), respectively. Primary studies of any type published in English will be included. Two reviewers will search Medline, EMBASE and Cochrane databases from inception to June 2020, retrieve relevant studies, and independently select the literatures and extract data from the included studies. The quality of each included study will be assessed by the Newcastle-Ottawa Scale score. The HR and 95% CI of each study will be pooled for survival outcome, and the standardised mean difference (SMD) with 95% CIs will be used for continuous outcomes. If meta-analysis is inappropriate, the result will only be reported qualitatively. Subgroup and sensitivity analyses will be considered to identify sources of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method will be applied to assess the level of evidence of this systematic review.Ethics and disseminationThere are no concerning ethical issues. The results will be published.PROSPERO registration numberCRD42019133665.

Tissue factor and its procoagulant activity on cancer‐associated thromboembolism in pancreatic cancer

“…In addition to TF levels at registration, we evaluated plasma TF levels at 3, 6, and 12 months in patients with CAT, except for five patients who developed CAT within 3 months after registration. Unlike a previous study 39 on the relationship between VTE and pancreatic cancer, we found that plasma TF levels were not significantly altered during the observation period; the mean changes compared with the values at registration were 1.28, −3.12, and −2.52 pg/mL at 3, 6, and 12 months, respectively (Figure 2D ). Thus, the positive predictive value (23.1%) was not improved, even when the later TF levels were used for estimation.…”

Gender-Specific Coagulation Profiles of Peripheral and Portal Blood May Help to Differentiate Malignant from Benign Pancreatic Tumour—Pilot Study

“…Directly influencing the coagulation profile, especially in the portal blood, is fairly common; however, potentially disturbing the interpretation of this study results in tissue factor (TF) overexpression on the tumor cells [ 13 ]. One of its effects is well described by our D-dimer group with a high concentration in portal blood [ 7 , 14 , 15 , 16 , 17 , 18 ]; however, the other can shorten the aPTT and raise the level of fibrinogen concentration ( Figure 2 ).…”

Multiparametric detection and outcome prediction of pancreatic cancer involving dual-energy CT, diffusion-weighted MRI, and radiomics

“…Recently published studies revealed strong correlations of intratumoral heterogeneity in malignant pancreatic lesions with tumor recurrence and survival [8][9][10]. Tumor masses can be quantified non-invasively by using dual-energy computed tomography iodine concentration (DECT-IC) [11,12] or diffusion-weighted magnetic resonance imaging (DWI) based on the random Brownian motion of water molecules within tissues [13]. Radiomics is a quantitative approach that poses the potential to extract a myriad of texture features from medical imaging by using miscellaneous mathematical extraction algorithms.…”